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ICD-10 Readiness
Recent News
- New Groups Effective Jan. 1, 2011
Published: - ICD-10 Update
Published: - CIGNA Address Change
Published: - V-Pay Cards
Published: - Include Patient Date of Birth on Claims
Published: - SL Modifiers
Published: - Midlands Choice EDI Contacts
Published: - Aetna Electronic Funds Transfer (EFT)
Published: - Aetna Electronic EOBs
Published: - Aetna Signature Administrators “Cheat Sheet”
Published: - Aetna Alternatives to Paper for When EDI Isn’t Practical
Published: - Aetna Corrected/Voided EDI Claims
Published: - Aetna Clinical Payment, Coding and Policy Changes
Published: - CIGNA Changing Name
Published: - Delegated Payer Claims
Published: - Access to Information During the Credentialing Process
Published: - United Security Life and Health Insurance
Published: - Changing To Online Newsletter
Published: - CIGNA Online Remittance Reports Available in 2011
Published: - Supporting Documentation for CIGNA Electronic Claims
Published: - CIGNA's Use of Modifiers 59 and 25
Published: - CIGNA Code Auditing
Published: - ICD-10 Code Translator
Published: - 5010 Update
Published: - New Aetna Radiology Preauthorization Requirements
Published: - Great-West Website Has New Look, Upgraded Features
Published: - Aetna Out-of-Network Benefit
Published: - Aetna Offers Multi-Payer Transactions via NaviNet at No Charge
Published: - Changes to 2011 Aetna Precertification List
Published: - Aetna Publishes CT Scan, MRI and Ultrasound Payment Policy
Published: - Mennonite Mutual Aid Announces Name Change
Published: - Paper Claims Must be Typed
Published: - Aetna Review of Hospital Acquired Conditions
Published: - Newsletter Readership Survey
Published: - TRISTAR Acquires American Administrators
Published: - Aetna Signature Administrators
Published: - Printed Directory Being Phased Out
Published: - Staff Achieves Clean Claim "Gold Standard'
Published: - BMI Administers Federal Plan in Iowa
Published: - ICD-10 Readiness
Published: - Principal LMHP Coverage
Published: - Principal and Magellan
Published: - OTC Reimbursement Requirements Changing
Published: - Aetna Policy and Practice Updates
Published: - CIGNA/Great-West Global Maternity Reimbursement Policy
Published: - CIGNA Modifier 59 Update
Published: - Out-of-Pocket Cost Estimator for Aetna Members
Published: - Aetna Laboratory Provider Change
Published: - New Online Directory Feature
Published: - American Family
Published: - BMI Administers Federal Insurance Plan in Iowa
Published: - New TPA for Creighton Student Plan
Published: - Aetna Policy and Practice Updates
Published: - Online Claims Save Time and "Green"
Published: - Aetna Payment Estimators Help Determine Patients’ Costs
Published: - 5010 Preparation Under Way
Published: - CIGNA ID Card Brochure
Published: - Groups Access Network through Sanford Health Plan
Published: - Webinar Invitation List
Published: - Five Steps to a Successful Appeal
Published: - Rehabilitation Order Issued for American Community
Published: - Great-West Accesses Midlands Choice in South Dakota
Published: - Highlights of 2010 CPT Changes
Published: - South Dakota Group Accesses Midlands Choice Network
Published: - CIGNA and Great-West Healthcare Precertification
Published: - Aetna Student Health Plans Addresses Have Changed
Published: - Aetna Online Resources
Published: - Keep Us Up to Date on Demographic Changes
Published: - NaviNet Link Includes Access to Both Aetna and CIGNA
Published: - Nebraska Law Impacts Lab Billing
Published: - New Great-West ID Cards
Published: - Questions About Our Website?
Published: - News Archives
By Jean Scharfenkamp, RHIA
When CMS published the ICD-10-CM/PCS Final Rule in January 2009, there were 58 months' lead time to prepare for the rule's October 2013 effective date. A third of those months have passed.
To review:
- On October 1, 2013, ICD-10-CM/PCS will replace ICD-9-CM for codes for medical diagnoses and inpatient procedures.
- ICD-10-CM/PCS has two components--ICD-10-CM for diagnosis coding by all providers and ICD-10-PCS for inpatient procedures.
- Electronic claims must transition to Version 5010 on January 1, 2012.
Many features of ICD-10-CM/PCS will be welcome, such as the ability to report left, right or bilateral sites of injury as well as separate encounters of care. ICD-10-CM also provides for specific clinical information within code sets that will help eliminate the need for additional documentation to substantiate provider billing. ICD-10-CM allows for the expansion of codes related to postoperative complications, substance abuse and injuries.
Key preparatory steps include:
- Developing awareness within your entire organization
- Creation of a multidisciplinary steering committee
- Detailed analysis by each functional area of needs, opportunities and challenges
- Staff responsible for assigning medical codes will need formal training to prepare for the multitude of differences between ICD-9-CM and ICD-10-CM/PCS, including increased biomedical knowledge required for correct assignment of codes. The American Health Information Management Association (AHIMA) estimates time needed for training and practice will be approximately 26 hours for ICD-10-CM and 34 hours for ICD-10-PCS.
There is still time to take advantage of the ICD-10-CM/PCS implementation timeframes. Resources are available through many websites that can assist you through the ICD-10-CM/PCS transition:
- General ICD-10 information
- ICD-10-CM Official Guidelines for Coding and Reporting
- ICD-10-CM files, information and General Equivalence Mappings (GEMs)
- ICD-10-PCS Coding Guidelines
- CMS Sponsored National Provider Conference Calls
- American Hospital Association
- American Health Information Management Association
- American Academy of Professional Coders
